Imprecise consonant articulation is common in speakers with Parkinson’s disease and can affect intelligibility. The research on the relationship between acoustic speech measures and intelligibility in Parkinson’s disease is limited, and most of the research has been conducted on English. This pilot study investigated aspects of consonant articulation acoustics in eleven Swedish speakers with Parkinson’s disease and six neurologically healthy persons. The focus of the study was on consonant cluster production, articulatory motion rate and variation, and voice onset time, and how these acoustic features correlate with speech intelligibility. Among the measures in the present study, typicality ratings of heterorganic consonant clusters /spr/ and /skr/ had the strongest correlations with intelligibility. Measures based on syllable repetition, such as repetition rate and voice onset time, showed varying results with weak to moderate correlations with intelligibility. One conclusion is that some acoustic measures may be more sensitive than others to the impact of the underlying sensory-motor impairment and dysarthria on speech production and intelligibility in speakers with Parkinson’s disease. Some aspects of articulation appear to be equally demanding in terms of acoustic realization for elderly healthy speakers and for speakers with Parkinson’s disease, such as sequential motion rate measures. Clinically, this would imply that for the purpose of detecting signs of disordered speech motor control, choosing measures with less variation among older speakers without articulation impairment would lead to more robust results. 

A bourgeoning number of studies have demonstrated that people living with dementia are capable of participating in a wide range of everyday activities when supported by care professionals or family carers. However, little remains known about the situated practices used by carers to support people living with dementia as active co-participants in novel joint activities. Taking the use of tablet computers as an example, this study focuses on the interactional organization of instructions in joint activities involving people living with dementia, who have no previous experiences of touchscreen technologies, and their carers. The study is based on forty-one video recordings of ten dyads, each comprising a person living with dementia and a carer, as they are using tablet computers with applications suited to individual interests. Drawing on multimodal interaction analysis, we show how the carers continually foster the accomplishment of their interlocutors, and rarely take over responsibility for closing an ongoing joint project themselves. Our findings suggest that the carers' instructions, realized as verbal and embodied directives, function as a form of scaffolding practice that facilitates the coordination of visual perception and embodied conduct for the participants living with dementia.

Purpose: This study challenges the notion that people living with dementia are unable to achieve novel learning without focussed intervention techniques. The purpose of this study is to explore how a woman living with dementia (Alzheimer’s disease) learns to use a tablet computer with support from communicative partners.

Method: The study is based on video recordings and the theoretical framework of learning as changing participation in joint activities. Quantitative and qualitative focus is on changes in the interactional organization

over the course of six weeks in the activity of using an augmentative and alternative communication application.

Results: Over time, the participant living with dementia, relies less on the expertise and explicit instructions of her communicative partners when navigating the application, and more on the immediate feedback provided by the tablet computer.

Conclusions: The findings suggest that novel learning still is possible for people living with dementia, even without the implementation of focussed interventions. This study further emphasizes the procedural nature of learning for people living with dementia as the woman’s embodied actions were carried out in an increasingly more direct fashion.

Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impacton users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, thisrequires evaluation that can accommodate diferent levels of cognitive impairment, alongside input from family and formalcaregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions forthe Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six nationalpilot sites to examine a number of variables including impact on the users, user acceptance of the individual services andthe overall platform, plus the economic case for the IN LIFE platform. The results confrmed the interest and need amongolder adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT).Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to payfor the platform. The fndings provide insights into existing barriers and challenges for adoption of ICT for older peopleliving with cognitive impairment.

Recent research has stressed the collaborative competences of people living with dementia, showing how they are capable of participating in a multitude of everyday activities when supported by cognitively healthy individuals. However, little is known about the collaborative work between different people living with dementia. Accordingly, this study aims to explore how people living with dementia, without the support of a cognitively healthy interlocutor, collaborate with other people living with dementia in an unfamiliar activity. The study is based on video recordings of three dyads, each comprising two individuals living with dementia, as they are using tablet computers with reminiscence and communication aiding applications. Drawing on multimodal interaction analysis, we show how the participants living with dementia treat the activities as joint endeavors and, when needed, engage in problem-solving sequences where they make their knowledge about how to progress within the activities publicly visible to their interlocutor. Our findings suggest that people living with dementia do collaborate with each other, and that the interactional labor between different people living with dementia is more symmetrical than what has been described in joint activities involving people living with dementia and cognitively healthy individuals.Previous article in issue

Introduction: Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a clients’ natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson’s disease.

Methods: Speech samples from eleven speakers with Parkinson’s disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples.

Results:  Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly, but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson’s disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions.

Conclusion: Within-speaker variability supports literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences and to inform the planning of interventions.

Objectives: This study investigated Swedish clinical professionals experiences of diagnostic pathways in dementia, focusing on the assessment of cognitive and communicative abilities. Methods: Interdisciplinary teams in Memory Clinics, General Practitioners in Primary Health Care, and Speech Language Pathologists were interviewed. The transcripts were analyzed using qualitative Content Analysis. Results: The study sheds light upon the perceived barriers and facilitators of good practice, e.g. time and clinical collaborations. Perspectives among professionals vary as to how informal and formal information and procedures are to be integrated and weighted. External factors (e.g. physical proximity of professions) have considerable influence on information availability, transmission, and diagnostic processes. Communication impairment does not emerge as a clinical priority. Conclusions: Published clinical guidelines notwithstanding, there is in practice no "gold standard" regarding diagnostic processes. Reorganization of services that impact feasibility of cross-disciplinary contact may negatively impact diagnostics.

This Swedish study investigates how persons living with dementia report their experiences of cognitive and linguistic testing, as well as their perspectives on the communicative resources and barriers they experience in daily interactions. Eight dyads were included in this qualitative exploratory study; eight persons with dementia and eight family members with whom they interact with daily. Semi-structured interviews, with questions focusing on experiences of diagnostic pathways as well as communicative and cognitive function in daily life, were carried out together with standard clinical testing. The data were analysed using qualitative content analysis. The results shed light on the experiences of uncertainty during the dementia assessment process related to the assessment tasks, the consequences of the assessment and receiving a diagnosis. We interpret this as a result of the unfamiliar clinical focus on function as measured in decontextualised tasks, compared to the participants view based on their abilities in everyday life. The study also reveals that adjustments in daily life that are necessitated by the consequences of neurological change are often developed in collaboration between the person with dementia and their conversation partners. There are, however, reports of conflicting feelings by the persons diagnosed with dementia, and by their families, as well as their views on how to best handle change, while maintaining a sense of being a competent person through the progression of disease.

Objectives In the present paper we aim to contribute to the understanding of how people with dementia experience using a web-based communication support application on a tablet computer in a group activity. The specific focus of the present paper is on perception of social inclusion among people with dementia in a group activity using digital communication support. Methods The study is based on interviews with participants in a communication group for people with dementia where the application CIRCA, specifically designed to support interaction involving people with dementia, was used. Five individuals with dementia were recruited from a residential care home where they lived in different wards. Seven group interviews with the participating persons with dementia following directly after each session were carried out. Results The views of the participants were generally very positive, regarding many aspects of the activity. In the present study, the group activity seemed more important and beneficial for the participants, than the specific use of the application in itself. Conclusions Taking part in a group activity targeting communication made participants with dementia feel that they were part of a social group, that they had learnt things, and that they had been able to contribute with their expertise to others. Clinical Implications Group activities targeting communication give people with dementia the opportunity to exercise their social inclusion practices. Group activities may render a feeling of social community and a sense of belonging to the participants. The use of digital communication support may enhance such activities.

Recent studies have demonstrated that people living with dementia, contrary to common believes, are capable of novel learning without structured interventions. Opportunities for learning throughout an individuals lifespan have been acknowledged as important factors in facilitating social participation and promoting wellbeing. However, little is still known about the situated practices used in the learning process for people living with dementia. This study aims to explore how people living with dementia in Swedish residential care facilities position, perceive, and assert, themselves as learners in a novel activity. The study is based on video recordings of eight people living with dementia, who for the first time use tablet computers as a social activity on a one-to-one basis with their formal caregivers. Through interaction analysis, we show how the participants living with dementia use the engagement displays of requests, accounts, formulations and metacomments to make their active undertaking in the ongoing activity public to their communication partner. Our findings suggest that people living with dementia might still perceive themselves as individuals capable of novel learning and that they are active and engaged agents in this process.

In the past years, there has been a flourishing of platforms dedicated to Active Assisted Living (AAL) and Active and Healthy Ageing (AHA). Most of them feature as their core elements intelligent systems for the analysis of multisource and multimodal data coming from sensors of various nature inserted in suitable IoT ecosystems. While progress in signal processing and artificial intelligence has shown how these platforms may have a great potential in improving the daylife of seniors or frail subjects, there are still several technological and non-technological barriers that should be torn down before full uptake of the existing solutions. In this paper, we address specifically this issue describing the outcome and creation process of a methodology aimed at evaluating the successful uptake of existing platforms in the field of AHA. We propose a pathway (as part of an overarching methodology) to define and select for Key Performance Indicators (KPIs), taking into account an extensive amount of parameters related to success, uptake and evolution of platforms. For this, we contribute a detailed analysis structured along with the 4 main actions of mapping, observing, understanding, and defining. Our analysis focuses on Platforms, defined as operating environments, under which various applications, agents and intelligent services are designed, implemented, tested, released and maintained. By following the proposed pathway, we were able to define a practical and effective methodology for monitoring and evaluating the uptake and other success indicators of AHA platforms. Besides, by the same token, we were able to provide guidelines and best practices for the development of the next-generation platforms in the AHA domain.

The purpose of the study is to explore when and how technology becomes a topic in interactions involving people with dementia and their carers. Three dyads of older women with dementia and their carers participated in the study. The dyads interacted in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (CIRCA) and personalized pictures and films (CIRCUS). The data included twenty-one video-recorded interactions. Topical episode analysis and transcripts of interaction were used to analyze and exemplify when and how technology was talked about in the dyads. The dyads were engaged in exploring the tablets, and six common ways of making technology a topic of conversation were identified: talk about tech problems, commenting actions, expressing uncertainty in navigation, instructing and explaining, expressing surprise, and talk about technical development. The dyads explored the tablets in ways that were reflected in the content of their conversations. If people with dementia and their carers should benefit from todays technology, such as there is evidence for the interactions examined in this study, their homes and daily environments must be equipped with sufficient internet access and technical support.

Multimodal interaktionsanalys används och har relevans för den slags sociala samspel som ofta benämns med termen atypisk interaktion. Med detta menas interaktion som involverar en eller flera samtalsdeltagare som i något avseende, exempelvis till följd av en kommunikativ funktionsnedsättning inte har möjlighet att kommunicera på samma sätt som en person utan funktionsnedsättning. Termen atypisk är naturligtvis inte okomplicerad, eftersom den implicerar att något skulle vara mer normalt och att atypisk interaktion därmed skulle vara onormal. Det är inte så termen ska tolkas här. Atypisk interaktion är socialt samspel i sin egen rätt, men sker under förutsättningar där någon persons språkliga eller kognitiva förmågor på något vis är nedsatta.

Purpose: The aim of the present study was to investigate the experiences of people with Parkinson’s disease and their close communication partners regarding disease-related communicative changes and participation in everyday conversations.

Materials and methods: Semi-structured qualitative interviews were conducted with six dyads consisting of a person with Parkinson’s disease and a close communication partner. The interview material was analysed through thematic analysis.

Results: The main theme was the experiences of barriers and facilitators for participation in conversations. Subthemes were experiences related to changes in voice and articulation, language and cognition, body language and facial expressions, fatigue, self-image, communicative initiative, and familiarity with conversation partner. The results show individual variation. A change observed in almost all dyads was the person with Parkinson’s disease participating less in conversations.

Conclusions: Assessment and interventions should be based on a broad perspective on communication, and individuals’ priorities should be foregrounded in intervention planning. Both the person with Parkinson’s disease and communication partners need to make adjustments for communication to work. Therefore, close communication partners should be included in assessment and intervention of communicationin Parkinson’s disease from an early stage.

Assessment of language and cognitive abilities are associated with clinical challenges. The aim of the present study was to learn more about the MMSE test process from a language perspective by looking in detail at the interaction between patient and tester. In addition, we aimed to further explore the relationship between linguistic and cognitive difficulties. The study was based on an analysis of 20 MMSE test dyads, 10 persons with aphasia and 10 persons with dementia, in interaction with speech and language pathologists. All conversations were audio and video recorded and transcribed verbatim according to Conversation Analytical principles. The thorough analysis of the interactions highlighted some main findings that affected the communicative project of the test interactions. Finally, the test results were summarized and analyzed. Through the analysis, some particularly challenging aspects emerged; the understanding of the verbal instructions, the handling of the instructions and the evaluation of the answers. The test results demonstrated that there were no significant differences between the two groups of participants MMSE results. The results in the language category did not seem to capture the language disorders among many of the participants more than the remaining test items. By qualitative analyses of the interactional aspects of test situations, information about both cognitive and linguistic abilities that otherwise would have been overlooked may be revealed.

Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.

Elderspeak refers to adapting ones language to a perceived language decline of an older interlocutor. Earlier studies have explored different features of elderspeak; some of these studies attribute positive outcomes to using elderspeak that facilitates communication, but other studies consider elderspeak a negative way of communicating that should be avoided. The aim of this study is to investigate a largely unexplored feature of elderspeak, namely sound prolongation in a multilingual context. There are five participants in this study: three carers and two care recipients in a residential care unit. The carers and care recipients have limited access to a shared spoken language. The data consist of video- and audio recordings of interaction between the participants. The recordings have been transcribed and analysed in accordance with Conversation Analytical methodology. The analysis shows that the carers use sound prolongation as part of their interactional repertoire in order to manage situations of distress. We conclude that in some distressful situations carers use of sound prolongation may help mitigating the care recipients emotional concerns since the source of agitations has been addressed properly. In other situations, the use of sound prolongation may lead to an escalation in distress, if the source of agitation is not addressed adequately. Our results bring to the fore that an interactional practice, such as the use of sound prolongation in the context of expressed distress must be interpreted in relation to the complexity of each and every situation participants find themselves in, their level of understanding, and the task/activity at hand.

Background: People with dementia frequently suffer from communication disabilities, which usually influence their quality of life. The communication disabilities may affect a persons possibility to participate in interaction as a result of reduced ability to initiate new topics and difficulties in contributing new information to maintain the conversational topic. Technical aids have been proved useful to facilitate communicative activities by supporting memory and stimulating communicative initiatives. Purpose: The aim of the present study is to further understandings of how digital communication support may be used in interaction involving people with dementia. A further aim is to investigate how participants experience communication with and without the use of communication aids. Methods: The study is carried out in a Swedish context, and three dyads of older women with dementia and professional carers participated in the study. The dyads interact in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (Computer Interactive Reminiscence and Communication Aid, CIRCA) and personalised pictures and films (Computer Interactive Reminiscence and Communication University of Sheffield, CIRCUS). The data include twenty-one video recorded activities. Results and Conclusion: The applications appear to provide support for the dyads in finding things to talk about. The participants talk both about the material and memories associated with the material. The participants experience the use of communication aids as positive.

Purpose: To examine repetition of stress and tonal word accents in real words and non-words in Swedish-speaking children with developmental language disorder (DLD), and to investigate the relation of prosodic repetition to measures of language ability.

Method: A cross-sectional study was undertaken with 30 monolingual Swedish-speaking children with DLD, mean age 4;11 (years;months) and 29 age-matched controls, mean age 5;1, who repeated words and non-words with systematically varying prosody. Group differences for the repetition of prosodic features, and correlations between repetition and phonology, grammar, and vocabulary, were explored.

Result: Children with DLD performed below controls on repetition of prosodic features of words and non-words. Repetition of stress and tonal word accent was not correlated with phonological production or receptive vocabulary, but a significant correlation was found between stress repetition in words and expressive grammar.

Conclusion: Repetition of stress and tonal word accents is challenging for children with DLD acquiring Swedish as their first language, but may not be a good indicator of general language ability. Prosody should be taken into account when interpreting results from clinically used word repetition (WR) and non-word repetition (NWR) tasks.

In some conversations involving persons with Alzheimers disease, the participants may have to deal with the difficulty that they do not share a common ground in terms of not only who is alive or dead, but even more, who could possibly be alive. It is as if the participants face a reality disjunction. There are very few empirical studies of this difficulty in conversations involving persons with Alzheimers disease or other kinds of dementia diagnoses. Often studies of confabulation have a focus on the behavior and experience of the healthy participants, but rarely on the interaction and the collaborative contributions made by the person with dementia. In the present article, we discuss various strategies used by all participants in an everyday conversation. The material consists of an hour long everyday conversation between a woman with Alzheimers disease and two healthy participants (relatives). This conversation is analyzed by looking at the organization of the interaction with an emphasis on how the participants deal with instances of reality disjunctions. The result from the analysis demonstrates that both the healthy participants as well as the person with dementia together skillfully avoid the face threats posed by reality disjunctive contributions by not pursuing argumentative lines that in the end might jeopardize both the collaborative and the personal relations.

Background: When it comes to aphasia assessments, many speech and language pathologists (SLPs) rely heavily on norm-referenced language tests, even though they are aware that certain important language skills can only be evaluated by analysis of conversational discourse. The formalized aphasia test situation is a typical example of institutional interaction, which differs in systematic ways from everyday conversations. This article examines conversations between persons with aphasia (PWAs) and SLPs in the two different contexts, a topic where previous research is limited. Aims: The aim is to compare the interactions between PWAs and SLPs in test conversations and in more everyday-like conversations and to relate the interactional data to the participants performance on the aphasia test battery. Methods amp; Procedures: Ten PWAs and three SLPs participated in the study. Each PWA participated in two conversations with an SLP, a test conversation, while performing tasks targeting the ability to produce sentences and narratives from an aphasia test battery, and a more everyday-like conversation. The conversations were audio and video recorded and thereafter transcribed. Three main observations considered to be important mechanisms for interaction organization were identified and calculated in the transcriptions. The test results were summarized and analyzed. Outcomes amp; results: The results demonstrated that there were a larger number of turns produced by the PWAs in the everyday conversations compared to the test conversations. Furthermore, there were more communicative initiatives and nonverbal contributions in the everyday conversations. The number of repairs initiated by the PWAs were equivalent, but looking at repair characteristics, it was found that repairs resolved within the same turn were found in the test conversations while repairs stretching over several turns were more frequent in the everyday conversations. Conclusions: The results of the present study demonstrated differences of the interaction between PWAs and SLPs in test conversations and in more everyday-like conversations. Furthermore, there seemed to be no obvious relationship between the participants actual test scores on the aphasia test battery and aspects of conversation that can be related to being a competent speaker.

Children with hearing impairment (HI) are at an increased risk of developing speech and language problems similar to those of children with developmental language disorder (DLD), including difficulties with phonology and grammar. This study investigated similarities and differences in phonological and grammatical production between children with bilateral sensorineural HI (n = 14) and children with DLD (n = 30) between 4-6 years of age and age-matched controls with typical language development and normal hearing (TLD) (n = 29), all with Swedish as their first language. Production of consonants, vowels, stress patterns and tonal word accents was assessed in a picture naming task, and in a word and nonword repetition task. Grammatical production was assessed for verb and noun morphology, and syntax. While performance for both children with HI and DLD were generally significantly below that of the controls with TLD, production of accents and syntax emerged as relative strengths. There were few differences between the between the children with HI and DLD, but noun-adjective agreement in predicative was more challenging for the children with HI. The results have implications for language assessment and planning of intervention.

Children who are deaf or hard of hearing (DHH) are at an increased risk of speech and language deficits. Nonword repetition (NWR) is a potential predictor of problems with phonology, grammar and lexicon in DHH children. The aim of the present study was to examine repetition of prosodic features and segments in nonwords by DHH children compared to children with normal hearing (NH) and to relate NWR performance to measures of language ability and background variables. In this cross-sectional study, 14 Swedish-speaking children with mild-profound sensorineural hearing loss, aged 4-6 years, and 29 age-matched controls with NH and typical language development participated. The DHH children used cochlear implants (CI), hearing aids or a combination of both. The assessment materials included a prosodically controlled NWR task, as well as tests of phonological production, expressive grammar and receptive vocabulary. The DHH children performed below the children with NH on the repetition of tonal word accents, stress patterns, vowels and consonants, with consonants being hardest, and tonal word accents easiest, to repeat. NWR performance was also correlated with language ability, and to hearing level, in the DHH children. Both prosodic and segmental features of nonwords are problematic for Swedish-speaking DHH children compared to children with NH, but performance on tonal word accent repetition is comparably high. NWR may have potential as a clinically useful tool for identification of children who are in need of speech and language intervention.

This presentation focuses on recycling of stories in conversations involving people with dementia. In dementia, communicative ability gradually deteriorates as the disease progresses typically leading to profound decline of communicative skills in the late stage. Of all of the domains affected by dementia diseases, communication is one of the areas where people with dementia and their caregivers experience most challenges. A significant characteristic for persons with dementia is a tendency to tell the same stories over and over (e.g. Hydén et al., 2013). While the significance conversational partners have on the organization of stories told by people with dementia are highly recognized (e.g. Hydén, et al., 2013; Hydén, 2011), how conversational partners to people with dementia orient toward recycling of stories are still in need of further investigation. In previous research, the phenomenon of recycling stories is mainly credited to the person with dementia. In our present study, we would like to propose another parallel point of view in which caregivers also tend to recycle stories repetitively in conversation with persons with dementia. We argue that recycling of stories in interaction involving people with dementia is a highly collaborative activity, and sometimes even initiated by conversational partners to people with dementia. In this presentation, we focus on how recycling of stories are sequentially organized is ordinary interaction between people with dementia and professional caregivers. The data consist of video recordings of 4 dyads (one person diagnosed with dementia and a professional caregiver in each dyad) totaling approximately 2,5 hours of recordings. In the analyses, we have focused specifically on how the telling of recycled stories is initiated in conversation, and what kind of feedback such stories receive. Our analyses show that recycled stories told by persons with dementia receive strong interactional support from conversational partners by, for example, the use of responses signaling newness and surprise (cf. Hydén et al., 2013). Conversational partners are also actively involved in the telling of recycled stories by, for example, asking guiding questions expanding the stories and use prompting techniques in cases where the person with dementia seem to have difficulties telling the whole story. In our analyses, we have also seen examples where conversational partners to people with dementia not only support the telling of recycled stories, but actually initiate such stories by instructing the person with dementia to talk about a specific topic.

Purpose: The aim of the present study was to identify problems with communication with persons with aphasia and persons with dementia in a collaborative interview setting with their significant others. In particular, to compare interactional practices used in order to resolve problems caused by specific symptoms. Method: Five persons with aphasia and five persons with dementia and their spouses participated in the study. Interviews were carried out couple by couple, and the interviews had a task-oriented character. The interviews were video and audio recorded. All interviews were transcribed. From the transcriptions categorisations according to previous literature were made. Result: The results demonstrated that repair sequences were frequent in interaction involving people with aphasia (PWA), and even more so in interaction involving persons with dementia (PWD). In general, it was the PWA/PWD that initiated the repair sequence more often than the spouse, thus keeping the general rule of a preference for self-initiated repair compared to other-initiated repair. Conclusion: The active involvement of the conversational partners in trouble solving sequences in interaction with PWA/PWD demonstrated in the present study indicates that the interactional style of the conversational partner to PWA/PWD important. This implies that conversation partner training programmes would be useful both for PWA and for PWD.

Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer’s disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.

Prosody can be described as the rhythmic, dynamic, and melodic aspects of language. Swedish has a relatively complex prosodic system compared to, for example, English. A large percentage of Swedish children with language impairment show prosodic problems to some extent. In the present study, non-word repetition was used to assess the phonological and prosodic abilities in children with phonological language impairment and children with phonological-grammatical language impairment. In the study, 10 children with phonological language impairment and 14 children with phonological-grammatical language impairment from 4;3 to 6;2 years of age participated. All children heard the same recorded non-words and words. The group with phonological language impairment received higher scores in all variables, compared to the group with phonological-grammatical language impairment. The results showed significant differences between the groups regarding production of vowels correct in words and production of phonemes correct in non-words as well as production of unstressed syllables in non-words and production of correct stress in non-words. Percent correctly produced vowels in words, but not in non-words, correlated significantly with grammatical ability.

The present article is a case study in which participation is investigated in terms of the use of interactional practices that enhance the involvement of a man with severe aphasia in activities that aim to capture his and his wifes experiences of everyday communication, and their views of his speech and language intervention. Five practices are identified: 1) collaborative telling, 2) formulations, 3) yes/no questions, 4) declaratives and 5) hint-and-guess strategies. It is demonstrated how participants (wife, a speech and language pathologist, and two research assistants) use of these practices are beneficial for making the viewpoints of the man with aphasia come across, despite his communication difficulties. Results are discussed in light of the importance of finding ways to make patients influence their own intervention, both in terms of a raised awareness of facilitative interactional practices and of activities such as interviews and retrospection sessions with patients and their significant others.

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The last decades, speech and language pathology services have been subject to changes, and there has been a growing demand for intervention activities to be effective and evidence-based. The aim of the present study was to investigate if and how video recording can be used to assess the use of features targeted in phonological intervention, in everyday talk by children with LI. Three five-year-old girls with phonological problems participated in the study, and data consist of video recordings of intervention sessions and of interaction at home. Three different paths of development were identified: Some targeted speech sounds are displayed in everyday interaction; Targeted speech sound is present in intervention-like activity; No displays of targeted sounds. The results of the present study clearly demonstrate that the use of video recordings, transcriptions and analysis of interaction outside of the clinical setting contribute important information that may guide planning, goal-setting and evaluation of intervention.

Models of speech and language intervention for communicative disabilities vary from structured programmes to more interactive and ecological methods (Fey, 1986). Ideally, a model for intervention should fit the interests and personality of the patient, focus on crucial aspects of speech and language, and be suited to the patients everyday communication needs (Johnston, 2006). The present article addresses how features of everyday interaction and speech and language intervention may be captured and used for children with language impairment (LI), their caretakers, and speech and language therapists (SLTs), within and outside of clinical practice. Specifically, the aim of the study is to explore the use of retrospection (Erickson and Schultz, 1982), based on Conversation Analytical (CA) methodology (e.g. Schegloff, 2007), and to establish if and how CA-based retrospection may contribute to raising participants awareness of their own and others interactional behaviours. Retrospection here refers to sessions where participants watch and comment on sequences of video-recordings from intervention, as well as from situations captured in a variety of everyday settings. Four children with LI and three speech and language therapists participated, as well as parents of the children. The procedure comprised analysis and transcription of video-recordings of everyday interaction and intervention involving the children, retrospections with the children, the parents of the children with LI, and the SLTs, and analysis and transcription of the recordings made of the retrospections. The analysis of the retrospections generated four categories of phenomena relevant for intervention and everyday interaction: (I) Observations of well-functioning interaction strategies; (2) Observations of less well-functioning interaction strategies; (3) Assessment of positive performance; and (4) Comments relating to intervention. The results show that CA-based retrospection may be used to raise the participants awareness of their own interactional behaviours, and provide the opportunity to discuss strategies relevant for both intervention and everyday interaction for children with LI.

It has been demonstrated that persons with dementia may be positioned as less competent than participants of the same age without dementia, and that persons with dementia possibly also are positioned as less competent than other older persons without dementia. In the present study, we aim to explore this further by analysing Swedish assessment meetings, in which needs and preferences are investigated for older persons without dementia. The material consists five audio-recorded assessment meetings, where there were at least two conversational partners present (a spouse and/or a child) and where the older person applying for social services was not diagnosed with dementia. The ages of the older persons ranged from 81 to 88, while the age of the relatives ranged from 46 to 93. The results of the present study demonstrate that older persons without dementia mainly are positioned as competent. However, it may be related to the degree of frailty, since the frailest person in the present study appears to be positioned as less competent than the other participants. The present paper adds to existing knowledge on how professionals in assessment meetings contribute to the positioning of older persons as competent and capable of making decisions. The results of the present article may be useful to promote development of education and training of communication skills for care mangers in assessments in order to further ensure that older persons with and without cognitive impairments can be actively involved in the creation and interpretation of their applications for social services.

In this paper the authors study if and how persons with dementia are orally positioned by others, and how they position themselves while participating in assessment meetings held in order to discuss access to supportive services. We analysed five assessment meetings where two older persons (one diagnosed with dementia and one without a dementia diagnosis) participated to investigate whether the person with dementia is positioned differently than the other old person. Interactional phenomena used to position the person with dementia were identified by interactional analysis.

The paperidentifies six phenomena that positioned the person with dementia as an individual with less interactional competence than the other participants: ignoring the person with dementia; voicing the feelings, capacity or opinion of the person with dementia; posing questions implying lack of competence; others' use of diagnosis; self-(re)positioning; and elderspeak. Persons with dementia are often orally positioned as less competent, indicating that they suffer further from discrimination than other older persons. We suggest that this has an impact on the participation of people with dementia in negotiations regarding their future care. The results indicate that social workers should be made aware that negative positioning exists and how it may affect the ability of people with dementia to contribute to discussions about their everyday life. Social workers should be encouraged to find strategies to reduce negative positioning in interaction.

The aim of the present study is to explore the form and function of clarification request sequences in interaction involving children with cochlear implants. Clarification request sequences are investigated in everyday interaction, and it is demonstrated that children with CI use both general/open and specific requests for clarification. It is also shown that there is relatively lower frequency of requests for clarification in interactions involving children with CI with high intelligibility scores. The results may be useful in clinical assessment and intervention demonstrating the importance of assessing interactional ability in everyday interaction.

In the present paper, speech and language intervention was investigated in order to explore the use and function of defusing practices. Defusing practices may be viewed as a special form of mitigation. In previous research, including studies on clinical interaction, mitigation has been described mainly as devices used in order to reduce the unwelcome effects of an utterance, or reduce the discomfort of bad news. Defusing practices, however, appear to serve somewhat different functions, which are examined here. Data comprises video and audio recordings of eight intervention sessions with children with language impairment (LI), and six intervention sessions with adults with aphasia, The analysis revealed the following kinds of defusing practices: circumscriptions/figurative language, diminutive words, words like ‘try’ or ‘test’, placing the problem outside of the patient, collective pronouns, diminishing the speech and language pathologist’s own competence, encouragement, and references to well-known phenomena. If speech and language therapists (SLPs) are made aware of the practice and function of defusing, they may make conscious use of these practices in order to reduce face-threatening situations in intervention

The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility, Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases students motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

In this study, segmental and prosodic aspects of word repetition and non-word repetition in typically developing children aged four to six years were investigated. Focus was on developmental differences, and on how tonal word accent and word length affect segment production accuracy. Prosodically controlled words and non-words were repeated by 44 Swedish-speaking children. Repetition accuracy for both words and non-words increased with age, and was higher for words than non-words. Further, tonal word accents I and II provided different conditions for segment repetition in favor of accent II during both word repetition and non-word repetition for older children, but only during word repetition for younger children. This suggests age-dependent differences regarding how prosody is stored and integrated with segments. The findings have theoretical significance regarding the role of prosody in the perception, processing and production of phonological information. There are also clinical implications concerning the interpretation of repetition tasks and the potential use of prosody in speech and language intervention.

According to the Simple View of Reading, reading ability can be divided into decoding and language comprehension. In the present study, decoding and comprehension's contribution to reading ability was studied both in children with reading difficulties and in children with typical reading ability. Decoding and comprehension was further divided into sub-components, and the contribution from non-verbal ability and general processing speed was also studied. The results demonstrated that decoding made the largest contribution to reading ability for children with reading difficulties, while language comprehension contributed the most for children with typical reading ability. The contribution of non-verbal ability was not significant, and general processing speed only made a significant contribution to decoding for typical children. The two factors in the Simple View of Reading, decoding and comprehension, together explained less of the variance in reading ability for children with reading difficulties than for children with typical reading ability.

This book argues for the importance of the participants' perspective within both theory and practice on the function of augmentative and alternative communication (AAC) aids in everyday talk-in-interaction. Interactional approaches such as Conversation Analysis (CA) and Topical episode analysis are used to analyze and demonstrate.

The aim of this study is to investigate the occurrence of elderspeak in a Swedish context and to describe its characteristics. Elderspeak refers to adjustments made in communication with elderly people; adjustments similar to those made in interaction with infants. Previous findings show that adjustments of communication are made within several linguistic domains, and are a part of the communicative environment of elderly people. Five people working in different forms of geriatric institutions participated in this study, and data consist of recordings of interactions between caregivers and residents (without dementia) and interactions between caregivers and colleagues. The recordings were transcribed and analyzed by means of perceptual, semantic and acoustic analyses. The findings demonstrate that caregivers, to a varying extent, adjusted their communication within several linguistic domains. The adjustments were mainly made within the prosodic domain, but there were also adjustments made within other language domains.

In many programmes within higher education, including speech language pathology (SLP) education, students are expected to develop collaborative skills alongside acquisition of theoretical knowledge. The focus of the present chapter is to evaluate SLP graduates’ opinions on how well prepared for the professional life they feel after their education. A questionnaire, focusing on perceived professional skills in relation to education, was distributed to former SLP students from two programmes with different applications of problem-based learning (PBL). A total of 55 students (69%) completed the questionnaire. PBL has been identified as one efficient way to facilitate the development of speech and language pathology students’ abilities to meet the demands of self-directed learning in everyday worklife. Moreover, it has been shown that the use of PBL throughout the programme is beneficial to the perception of attaining general competencies. It is also demonstrated that the students from both the PBL throughout and the semi-PBL curricula rated themselves high on many specific competencies.

The present article focuses on feedback in storytelling involving people with Alzheimer’s disease (AD), and how feedback is related to the ways participants establish a common ground (Clark 1996) in interaction. The establishment of common ground is important in all kinds of interaction and becomes an especially intricate process if participants have AD, since the achievement of common ground requires the ability to draw from knowledge and experiences relating to past as well as present events; an ability that is often hampered by the disease. Analyses show that other aspects than the actual content of the conversation are important for the participants – for instance being together, supporting the positive identities both presented in the story and embodied in the socially rewarding activity that they manage to engage in, implying that the participants create and sustain a common ground not so much about the story-layer as of the storytelling activity.

Growth is one of the human body’s most intricate processes: each body part or region has its own unique growth patterns. Yet at the individual and population levels, growth patterns are sensitive to adverse conditions, genetic predispositions, and environmental changes. And despite the body’s capacity to compensate for these developmental setbacks, the effects may be far-reaching, even life-long. The Handbook of Growth and Growth Monitoring in Health and Disease brings this significant and complex field together in one comprehensive volume: impact of adverse variables on growth patterns; issues at different stages of prenatal development, childhood, and adolescence; aspects of catch-up growth, endocrine regulation, and sexual maturation; screening and assessment methods; and international perspectives. Tables and diagrams, applications to other areas of health and disease, and summary points help make the information easier to retain. Together, over 180 self-contained chapters in 15 sections cover every area of human growth, including:

• Intrauterine growth retardation.
• Postnatal growth in normal and abnormal situations.
• Cells and growth of tissues.
• Sensory growth and development.
• Effects of disease on growth.
• Methods and standards for assessment of growth, and more.

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Nonverbal vocalizations in dementia are important clinically since they generally have been regarded as disruptive behavior that is disturbing. The aim of the present study is to describe the interactional pattern, including the prosodic package, of nonverbal vocalizations in a participant in a late stage of dementia. The acoustic analysis shows that the vocalizations do not differ significantly from the verbal utterances regarding mean fundamental frequency or pitch range. The mean fundamental frequency, F(0), of the utterances from Anna was significantly higher than the mean F(0) from the other elderly participants. The analysis demonstrates that there is a singing-like type of vocalizations that does not resemble the previously described patterns of nonverbal vocalizations. This pattern of the nonverbal vocalization does not resemble the intonation of Annas verbal utterances. The other participants perceive Annas vocalizations as potentially meaningful turns. Nonverbal vocalizations in clinical settings should be taken as communicative contributions.

The purpose of the present study was to investigate the relationship between perception and production of metrical patterns in Swedish children with language impairment (LI), in order to add to the knowledge on underlying explanations of LI. A further aim was to explore whether omissions are mainly related to prosodic aspects or to linguistic function. Children with LI omitted significantly more unstressed syllables than did children with typical language development. Exploration of the relationship between perception and production of phrasal stress patterns demonstrated that children with LI might be divided into three subgroups: Group a: children who perform better on perception than production; Group b: children who perform better on production than perception; and Group c: children with rather poor results on both perception and production.